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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629162
Report Date: 12/07/2021
Date Signed: 12/07/2021 11:56:15 AM

Document Has Been Signed on 12/07/2021 11:56 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MIRANDA, KEYLLY FAMILY CHILD CAREFACILITY NUMBER:
376629162
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 10CENSUS: 4DATE:
12/07/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Keylly MirandaTIME COMPLETED:
12:00 PM
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On 12/07/21 at 9:45AM, LPA, Luigi Gargaro, conducted an unannounced capacity increase visit with the applicant. The one story home was toured and inspected to ensure an environment safe for the care and supervision of children. Present were the applicant, her cleared and associated husband, Aniano Miranda and four day care children. The fire extinguisher and smoke and carbon monoxide detectors meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. Analyst inquired of the applicant about whether there were any bodies of water or weapons in the home and she replied no. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. The home appears to be large enough to comfortably accommodate 14 children. Fire clearance was received on 11/30/21. First Aid and CPR certifications expire on July of 2023 for Ms. Miranda and September of 2023 for her spouse. Last fire drill was conducted on 10/13/21 at the facility whlle the last earthquake drill was conducted on 11/15/21. Licensee and spouse have required immunizations. Licensee and spouse completed Mandated Reporter Training on 06/10/21. Facility roster is maintained and was reviewed.

Applicant will be using the following rooms for childcare: the living room, the second home bedroom and the bathroom. The following areas will be off limits: the first bedroom (listed as "room 3" on the facility sketch), the kitchen, the bedroom behind the kitchen (listed as "room 1" on the facility sketch) and the garage. The first bedroom is made off limits with a locking door handle. The kitchen is made off limits with a secured, extended child safety gate that is installed between the living room and the kitchen. The garage entrance door and the back bedroom are located behind the off limits kitchen and are therefore inaccessible. The applicant has sufficient toys and equipment available.

The home has a fenced backyard available for outdoor play and a gated front yard. The back yard has a shed that is made inaccessible with a sliding bolt secured with a padlock.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MIRANDA, KEYLLY FAMILY CHILD CARE
FACILITY NUMBER: 376629162
VISIT DATE: 12/07/2021
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There is one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards are free from all loose articles and objects. The provider physically checks on sleeping infants every 15 minutes. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age. The provider places infants up to 12 months of age on their backs for sleeping.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA and licensee discussed California Megan's Law and he provided licensee with the website address: www.meganslaw.ca.gov for her to review information regarding her facility on a regular basis.

The following information was reviewed with the applicant: information on reporting requirements for suspected child abuse and unusual incidents, children’s records, immunizations, adults living or working in the home and related civil penalties, shaken baby syndrome, and SIDS. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers are not allowed in day care.

The home appears to be in sufficient compliance and as no corrections are needed, a license for 14 will be issued effective today. Analyst printed a copy of the Notice Of Site Visit today and had licensee place it in her facility notice area before he left the home.

SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2021
LIC809 (FAS) - (06/04)
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